Diagnostic Accuracy of Magnetic Resonance Spectroscopy in Diagnosing Glioblastoma, taking Histopathology as Gold Standard
DOI:
https://doi.org/10.51985/Keywords:
Glioblastoma; Magnetic Resonance Spectroscopy; Histopathology; Diagnostic Accuracy; Brain NeoplasmsAbstract
Objective: To determine the diagnostic accuracy of magnetic resonance spectroscopy (MRS) in diagnosing glioblastoma in patients with focal brain lesions, taking histopathology as the gold standard.
Study Design and Setting: Cross-sectional validation study conducted at the Department of Radiology, Madinah Teaching Hospital, Faisalabad.
Methodology: A total of 148 patients aged 20-60 years with focal brain lesions larger than 5 mm and lesion duration of more than one month were enrolled through non-probability consecutive sampling. All patients underwent proton MRS using a 1.5 Tesla MRI system with a single-voxel point-resolved spectroscopy technique. MRS diagnosis of glioblastoma was based on raised choline peak, reduced NAA/Cr ratio, raised Cho/NAA ratio, and raised Cho/Cr ratio. Post-biopsy or post-excision histopathology was used as the gold standard. Sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, likelihood ratios, and receiver operating characteristic curve analysis were calculated using SPSS version 25.0.
Results: The mean age was 42.76 +/- 10.84 years, and 92 (62.2%) patients were male. Histopathology confirmed glioblastoma in 116 (78.4%) patients. MRS showed sensitivity of 93.1%, specificity of 68.8%, positive predictive value of 91.5%, negative predictive value of 73.3%, and overall diagnostic accuracy of 87.8%.
Conclusion: MRS is a highly sensitive non-invasive adjunct to conventional MRI for preoperative assessment of suspected glioblastoma; however, histopathological confirmation remains essential because specificity and negative predictive value were moderate.
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